The symptoms caused by the moderate or excessive (i.e., intoxicating) intake of alcohol are unpleasant, particularly in the post-exhilaration or veisalgia stage (i.e., “hangover”). Such symptoms include, for example, substantial physical and mental fatigue, nausea, loss of appetite, tremors of the hand and limbs (the “shakes”), joint weakness/pain, dehydration, irritability, lack of coordination, concentration difficulties, sleeplessness, impaired memory and visual-spatial skills, headache, drowsiness, dry mouth, dizziness, gastro-intestinal complaints, sweating, and anxiety.
Excessive drinking is defined as four or more drinks per occasion for women; five or more drinks per occasion for men; high weekly use; and any alcohol use by pregnant women or those under age 21. Excessive drinking typically is associated with attaining blood alcohol content (BAC) of 0.055% and above.
However, even moderate drinking causes substantial hangover symptoms in some people. Moderate drinking is defined as: no more than 3-4 standard drinks per drinking episode; no more than 9 drinks per week for women and 12-14 for men; and limiting rate of drinking to keep BAC below 0.055%.
Interestingly, hangover symptoms develop when BAC returns to zero. It is not known why these symptoms are present after alcohol and its metabolites are eliminated from the body. (“The alcohol hangover—a puzzling phenomenon,” Joris C. Verster, Alcohol and Alcoholism, DOI:http://dx.doi.org/10.1093/alcalc/agm163; 124-126 (January 2008))
Additionally, congeners, i.e., trace chemicals produced during fermentation contained in some beverages, contribute to hangover symptoms. Studies have shown that high-congener, darker-colored liquors like bourbon and whiskey result in more severe hangover symptoms than lighter-colored or clear liquors like vodka, which has none. (“The role of beverage congeners in hangover and other residual effects of alcohol intoxication: a review,” Rohsenow et al., Curr Drug Abuse Rev., 3(2):76-9 (June 2010).) It has been suggested that one particular congener, methanol, perhaps accounts for the enduring effects of hangover symptoms.
According to 2011 and 2013 studies published in the American Journal of Preventive Medicine, excessive drinking and resulting hangovers cost the American economy more than $223 billion nationally. The Center for Disease Control and Prevention (which studies the negative externalities of alcohol consumption each decade) estimates that over seventy percent of such costs come from lost workplace productivity, which suggests that the economic drag from hangovers is about $160 billion.
For such reasons, a search for remedies for hangover symptoms has persisted. A 2005 study assessed the clinical evidence for the effectiveness of medical interventions for preventing or treating alcohol hangover (“Interventions for Preventing or Treating Alcohol Hangover. Systemic Review of Randomised Controlled Trials,” Pittler et al., BMJ 331(7531):1515-1518 (2005 Dec. 24)). In particular, eight randomized controlled trials assessing eight different interventions were reviewed. The agents tested were propranolol, tropisetron, tolfenamic acid, fructose or glucose, and the dietary supplements Borago officinalis (borage), Cynara scolymus (artichoke), Opuntia ficus-indica (prickly pear), and a yeast based preparation. Significant intergroup differences for overall symptom scores and individual symptoms were reported only for tolfenamic acid, γ linolenic acid from B officinalis, and a yeast based preparation. It was concluded that “No compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover.”
Clearly, there is a need for a more effective and accessible manner by which to manage the symptoms of veisalgia.